Effects of irradiation of chest on pulmonary function in man

1961 ◽  
Vol 16 (2) ◽  
pp. 331-338 ◽  
Author(s):  
C. Emirgil ◽  
H. O. Heinemann

Fifteen patients, free from cardiac and pulmonary disease, but receiving radiotherapy for carcinoma of the breast or carcinoma of the lung, were studied to determine the effect of irradiation on pulmonary function. Lung volumes, the distribution of inspired air, the levels of gases in the arterial blood, the diffusing capacity of the lung, and the mechanics of breathing were measured before and at varying intervals after the completion of radiotherapy. The results showed: early and progressive reduction of inspiratory capacity (IC) and residual volume (RV), decreasing the total lung capacity (TLC) without changing the RV/TLC ratio; unchanged distribution of inspired air; mild hypoxemia at rest; reduced diffusing capacity of the lung for carbon monoxide; and an early and progressive decrease in pulmonary compliance. These observations indicate that irradiation of the chest is complicated by a decrease in lung volumes, an impairment of the diffusing capacity, and an increase in the work of breathing. Submitted on September 6, 1960

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yoshitake Yamada ◽  
Minoru Yamada ◽  
Shotaro Chubachi ◽  
Yoichi Yokoyama ◽  
Shiho Matsuoka ◽  
...  

Abstract Currently, no clinical studies have compared the inspiratory and expiratory volumes of unilateral lung or of each lobe among supine, standing, and sitting positions. In this prospective study, 100 asymptomatic volunteers underwent both low-radiation-dose conventional (supine position, with arms raised) and upright computed tomography (CT) (standing and sitting positions, with arms down) during inspiration and expiration breath-holds and pulmonary function test (PFT) on the same day. We compared the inspiratory/expiratory lung/lobe volumes on CT in the three positions. The inspiratory and expiratory bilateral upper and lower lobe and lung volumes were significantly higher in the standing/sitting positions than in the supine position (5.3–14.7% increases, all P < 0.001). However, the inspiratory right middle lobe volume remained similar in the three positions (all P > 0.15); the expiratory right middle lobe volume was significantly lower in the standing/sitting positions (16.3/14.1% decrease) than in the supine position (both P < 0.0001). The Pearson’s correlation coefficients (r) used to compare the total lung volumes on inspiratory CT in the supine/standing/sitting positions and the total lung capacity on PFT were 0.83/0.93/0.95, respectively. The r values comparing the total lung volumes on expiratory CT in the supine/standing/sitting positions and the functional residual capacity on PFT were 0.83/0.85/0.82, respectively. The r values comparing the total lung volume changes from expiration to inspiration on CT in the supine/standing/sitting positions and the inspiratory capacity on PFT were 0.53/0.62/0.65, respectively. The study results could impact preoperative CT volumetry of the lung in lung cancer patients (before lobectomy) for the prediction of postoperative residual pulmonary function, and could be used as the basis for elucidating undetermined pathological mechanisms. Furthermore, in addition to morphological evaluation of the chest, inspiratory and expiratory upright CT may be used as an alternative tool to predict lung volumes such as total lung capacity, functional residual capacity, and inspiratory capacity in situation in which PFT cannot be performed such as during an infectious disease pandemic, with relatively more accurate predictability compared with conventional supine CT.


PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1013-1017
Author(s):  
Thomas G. Keens ◽  
Margaret H. O'Neal ◽  
Jorge A. Ortega ◽  
Carol B. Hyman ◽  
Arnold C.G. Platzker

Pulmonary function tests were performed in 12 thalassemia patients on a hypertransfusion program (age 18.4 ± 2.6 SEM years) to determine the presence of any abnormalities of lung function. These included spirometry, expiratory flow rates, body plethysmography, single-breath nitrogen washout, single breath carbon monoxide diffusing capacity, and arterial blood gases. Only one patient had normal pulmonary function. Arterial hypoxemia was present in ten of 12 patients at rest. The total lung capacity (TLC) was normal. The residual volume was abnormally increased in five of 12 patients. The slope of phase III of single breath nitrogen washout curve was abnormal in five of 12 patients, but the closing volume was normal. The maximal expiratory flow rate at 60% total lung capacity was decreased in four of 12 patients, suggesting the presence of small airway disease. The single breath carbon monoxide diffusing capacity was normal in all patients. These pulmonary function abnormalities did not correlate with age or the cumulative amount of iron via blood transfused. The small airway obstruction, hyperinflation; and hypoxemia observed in thalassemia patients on a hypertransfusion program may result from the basic disease, iron deposition in the lungs, or other factors.


1980 ◽  
Vol 49 (4) ◽  
pp. 566-570 ◽  
Author(s):  
S. S. Cassidy ◽  
M. Ramanathan ◽  
G. L. Rose ◽  
R. L. Johnson

The diffusing capacity of the lung for carbon monoxide (DLCO) varies directly with lung volume (VA) when measured during a breath-holding interval. DLCO measured during a slow exhalation from total lung capacity (TLC) to functional residual capacity (FRC) does not vary as VA changes. Since VA is reached by inhaling during breath holding and by exhaling during the slow exhalation maneuver, we hypothesized that the variability in the relation between DLCO and VA was due to hysteresis. To test this hypothesis, breath-holding measurements of DLCO were made at three lung volumes, both when VA was reached by inhaling from residual volume (RV) and when Va was reached by exhaling from TLC. At 72% TLC, DLCO was 22% higher when VA was reached by exhalation compared to inhalation (P < 0.02). At 52% TLC, DLCO was 19% higher when VA was reached by exhalation compared to exhalation (P < 0.005). DCLO measured during a slow exhalation fell on the exhalation limb of the CLCO/VA curve. these data indicate that there is hysteresis in DLCO with respect to lung volume.


1960 ◽  
Vol 15 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Stanley S. Heller ◽  
William R. Hicks ◽  
Walter S. Root

Lung volume determinations (tidal volume, inspiratory capacity, inspiratory reserve volume, expiratory reserve volume, vital capacity, maximum breathing capacity, functional residual capacity, residual volume, and total lung capacity) were carried out on 16 professional singers and 21 subjects who had had no professional vocal training. No differences were found between the two groups of subjects, whether recumbent or standing, which could not be explained upon the basis of age, size, or errors involved in making the measurements. Submitted on March 24, 1959


1980 ◽  
Vol 48 (6) ◽  
pp. 1052-1059 ◽  
Author(s):  
J. Takezawa ◽  
F. J. Miller ◽  
J. J. O'Neil

We measured the single-breath diffusing capacity for carbon monoxide (DLCO), total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV) in anesthetized male hamsters, rats, guinea pigs, and rabbits whose weights varied from 40 to 3,500 g. TLC (defined as an airway pressure of 25 cmH2O) was calculated by neon dilution. The DLCO was estimated by a modification of the single-breath method. There was a high correlation between body weight and our measurement of both the diffusing capacity and the lung volumes. No significant difference in DLCO was observed in rats when measured in different body positions, at airway pressures of 10 or 20 cmH2O, from FRC or RV, in male or female rats, or following hyperventilation.


1994 ◽  
Vol 77 (4) ◽  
pp. 2005-2014 ◽  
Author(s):  
A. R. Elliott ◽  
G. K. Prisk ◽  
H. J. Guy ◽  
J. B. West

Gravity is known to influence the mechanical behavior of the lung and chest wall. However, the effect of sustained microgravity (mu G) on lung volumes has not been reported. Pulmonary function tests were performed by four subjects before, during, and after 9 days of mu G exposure. Ground measurements were made in standing and supine postures. Tests were performed using a bag-in-box-and-flowmeter system and a respiratory mass spectrometer. Measurements included functional residual capacity (FRC), expiratory reserve volume (ERV), residual volume (RV), inspiratory and expiratory vital capacities (IVC and EVC), and tidal volume (VT). Total lung capacity (TLC) was derived from the measured EVC and RV values. With preflight standing values as a comparison, FRC was significantly reduced by 15% (approximately 500 ml) in mu G and 32% in the supine posture. ERV was reduced by 10–20% in mu G and decreased by 64% in the supine posture. RV was significantly reduced by 18% (310 ml) in mu G but did not significantly change in the supine posture compared with standing. IVC and EVC were slightly reduced during the first 24 h of mu G but returned to 1-G standing values within 72 h of mu G exposure. IVC and EVC in the supine posture were significantly reduced by 12% compared with standing. During mu G, VT decreased by 15% (approximately 90 ml), but supine VT was unchanged compared with preflight standing values. TLC decreased by approximately 8% during mu G and in the supine posture compared with preflight standing. The reductions in FRC, ERV, and RV during mu G are probably due to the cranial shift of the diaphragm, an increase in intrathoracic blood volume, and more uniform alveolar expansion.


Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Roberta Pisi ◽  
Marina Aiello ◽  
Luigino Calzetta ◽  
Annalisa Frizzelli ◽  
Veronica Alfieri ◽  
...  

<b><i>Background:</i></b> The ventilation heterogeneity (VH) is reliably assessed by the multiple-breath nitrogen washout (MBNW), which provides indices of conductive (<i>S</i><sub>cond</sub>) and acinar (<i>S</i><sub>acin</sub>) VH as well as the lung clearance index (LCI), an index of global VH. VH can be alternatively measured by the poorly communicating fraction (PCF), that is, the ratio of total lung capacity by body plethysmography to alveolar volume from the single-breath lung diffusing capacity measurement. <b><i>Objectives:</i></b> Our objective was to assess VH by PCF and MBNW in patients with asthma and with COPD and to compare PCF and MBNW parameters in both patient groups. <b><i>Method:</i></b> We studied 35 asthmatic patients and 45 patients with COPD. Each patient performed spirometry, body plethysmography, diffusing capacity, and MBNW test. <b><i>Results:</i></b> Compared to COPD patients, asthmatics showed a significantly lesser degree of airflow obstruction and lung hyperinflation. In asthmatic patients, both PCF and LCI and <i>S</i><sub>acin</sub> values were significantly lower than the corresponding ones of COPD patients. In addition, in both patient groups, PCF showed a positive correlation with LCI (<i>p</i> &#x3c; 0.05) and <i>S</i><sub>acin</sub> (<i>p</i> &#x3c; 0.05), but not with <i>S</i><sub>cond</sub>. Lastly, COPD patients with PCF &#x3e;30% were highly likely to have a value ≥2 of the mMRC dyspnea scale. <b><i>Conclusions:</i></b> These results showed that PCF, a readily measure derived from routine pulmonary function testing, can provide a comprehensive measure of both global and acinar VH in asthma and in COPD patients and can be considered as a comparable tool to the well-established MBNW technique.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Kazushige Shiraishi ◽  
Torahiko Jinta ◽  
Naoki Nishimura ◽  
Hiroshi Nakaoka ◽  
Ryosuke Tsugitomi ◽  
...  

Background. Although digital clubbing is a common presentation in patients with interstitial lung disease (ILD), little has been reported regarding its role in assessing patients with ILD. This study evaluated patients with ILD for the presence of clubbing and investigated its association with clinical data. Methods. We evaluated patients with ILD who visited the teaching hospital at which the study was conducted, between October 2014 and January 2015. Clubbing, evaluated using a Vernier caliper for individual patients, was defined as a phalangeal depth ratio > 1. We examined the association of clubbing with clinical data. Results. Of 102 patients with ILD, we identified 17 (16.7%) with clubbing. The partial pressure of oxygen in arterial blood was lower (65.2 ± 5.9 mmHg versus 80.2 ± 3.1 mmHg; p=0.03), serum Krebs von den Lugen-6 (KL-6) levels were higher (1495.0 ± 277.4 U/mL versus 839.1 ± 70.2 U/mL; p=0.001), and the percent predicted diffusing capacity of carbon monoxide was lower (50.0 ± 6.0 versus 73.5 ± 3.1; p=0.002) in these patients with clubbing. Conclusions. Patients with clubbing had lower oxygen levels, higher serum KL-6 levels, and lower pulmonary function than those without clubbing.


1994 ◽  
Vol 15 (10) ◽  
pp. 403-411
Author(s):  
Gary A. Mueller ◽  
Howard Eigen

Pulmonary function testing is an important tool in the evaluation of children who have or are suspected of having lung disease. Of particular importance, pulmonary function testing provides objective and reproducible measurements, which then can be used to follow the response to therapy. The measurements of air flow and lung volumes are the mechanical pulmonary function tests used most commonly. However, measurements of the efficiency of gas exchange also are considered a test of pulmonary function and can be assessed by such methods as arterial blood gas and oximetry. This article focuses on those tests readily available to the pediatrician in the office or hospital. Measuring pulmonary function regularly is analogous to measuring blood pressure in patients who have hypertension, allowing the physician to follow a measurement directly associated with the pulmonary disease process. As with other clinical tests, pulmonary function measurements are most effective when used to answer a specific question about the patient. For example, in a child who presents having a persistent cough and a family history of asthma, the diagnosis may be asthma, and the question "Does the child have airflow obstruction consistent with asthma?" can be answered by spirometry. Spirometry The parameters commonly measured in the assessment of respiratory function are lung volumes, air flows and timed volumes, and airway reactivity.


PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 181-193
Author(s):  
C. D. Cook ◽  
P. J. Helliesen ◽  
L. Kulczycki ◽  
H. Barrie ◽  
L. Friedlander ◽  
...  

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43. Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio. Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.] Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.


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